The proposed project will demonstrate the ability of the rural, community-based health provider to deliver quality, up-to-date cancer care utilizing organized local oncology support services and appropriate, coordinated tertiary referral services. Through the use of a nurse-oncologist and health educator, the Frontier Nursing Service will provide organized professional cancer education, develop specialized cancer nursing services, improve cancer data management through the maintenance of a Tumor Registry, coordinate a local Hospice program, and improve referral arrangements with university-based tertiary centers so as to improve communications and provide appropriate levels of care while minimizing disruption to the rural patient. Formal evaluation of the project's impact on patterns of patient care, community attitudes and professional skills will be undertaken by contract to a university-based team.